Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review

Abstract

Orbital decompression is a surgical procedure aimed at increasing the orbital volume and/or decreasing the volume of the orbital fat. The indications for orbital decompression are determined in the course of thorough eye examination. An important objective of examination of a patient with thyroid eye disease (TED) is determination of inflammation activity and severity. Orbital decompression is a surgical procedure that can be performed in both the active and nonactive stages of the disease. However, the indications for the surgery in these cases are different. Optic neuropathy and severe corneal disease are threatening complications that may lead to permanent visual loss and generally occur in the presence of active orbital inflammation. If treatment with high-dose corticosteroids has proven ineffective, an urgent surgical procedure consisting of orbital decompression and, in case of involvement of the cornea, eyelid and corneal surgery has to be performed. Owing to significant progress in technology, improvement of methods and accumulated experience over the past decade, the indications for bone orbital decompression have extended compared to the time when this procedure was used only in patients with extremely severe TED. The most common complication of the orbital decompression is the development or deterioration of previously existing binocular diplopia and strabismus. In addition, other parameters may change as well, including the position of the globe, the eyelids, the angle of deviation of the eye, and intraocular pressure. Thus, bone orbital decompression is a major step of a comprehensive, often multistage, system of rehabilitation of patients with severe refractory TED.

Keywords:

• Graves’ disease
• thyroid eye disease
• orbital decompression
• ophthalmopathy
• corneal ulcer
• tarsoraphy

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Orbital decompression in the system of treatment for complicated thyroid eye disease: case report and literature review [corrigendum]

Acknowledgments

The authors acknowledge Dr Yury I Philippov for the help in formatting the manuscript and for submitting it to the journal.

Author contributions

NY Sviridenko and IM Belovalova (endocrinologists) supervised the patient. YO Grusha and DS Ismailova (ophthalmologists and surgeons) supervised the patient. All authors equally contributed to the case report data acquisition, and its analysis and interpretation. All authors substantially contributed to drafting, editing, and revising the article. They all read and approved the final version of the manuscript to be published and agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Disclosure

The authors report no conflicts of interest in this work.